Characteristics and prognosis of synchronous multiple primary lung cancer after surgical treatment: A systematic review and meta‐analysis of current evidence

Abstract

Background This study aims to quantitatively summary the characteristics of synchronous multiple primary lung cancer (sMPLC), postoperative mortality, long‐term prognosis, and prognostic effects of potential clinical parameters in patients with sMPLC after surgery. Methods PubMed and Embase databases were systematically searched to identify studies that explored the prognosis of patients with sMPLC after surgery. Results Fifty‐two studies with 3486 participants were included, and clinical characteristics were quantitatively summarized. The pooled proportion of sMPLC in lung cancer was 2.0% (95%CI, 1.6%–2.5%) with an increasing trend over time, and postoperative mortality was 1.4% (95%CI, 0.5%–2.7%) with a decreasing trend over time. The 5‐year survival rate was 44.9% (95%CI, 37.4%–52.6%) and all long‐term survival rates showed increasing trends over time. Poor long‐term prognosis was observed in both limited resection (HR = 1.357, 95%CI, 1.047–1.759, p = 0.0210) and pneumonectomy (HR = 2.643, 95%CI, 1.539–4.541, p = 0.0004) by comparison of anatomical resection. Other clinical parameters of age, gender, smoking status, FEV1, and lymph node metastasis significantly impacted the long‐term prognosis (all p < 0.05). Conclusions The proportion of sMPLC in lung cancer and 5‐year survival rate are increasing, while postoperative mortality is decreasing trend over time. Lobectomy should be preferred, while pneumonectomy should be avoided for sMPLC. Age, gender, FEV1, smoking, tumor size, surgical methods, and lymph node status are prognostic factors for sMPLC. Considering the heterogeneity and publication bias, these findings should be treated with caution.

Multiple Primary Lung Tumors of Different Pathological Types Including Squamous Cell Carcinoma, Adenocarcinoma, and Mixed Squamous Cell and Glandular Papilloma: A Case Report

“…Adenocarcinoma accounts for the largest portion, among which acinar, lepidic, and papillary adenocarcinomas are the three most frequent architectural patterns. 10 , 11 In 1975, Martini and Melamed proposed the first clinicopathological diagnostic criteria for MPLC. 3 This standard has been widely accepted by clinicians and pathologists, and has been an important diagnostic reference for many years.…”

Next-generation sequencing revealed synchronous double primary lung squamous carcinoma: a case report

“…Synchronous MPLC (sMPLC) was first discovered by Beyreuther in 1924. 10 Despite its rarity, the incidence of sMPLC has been increasing. 11 , 12 Smoking, lymph node metastasis, and pleural invasion are independent risk factors regarding the prognosis of patients with sMPLC, while early detection and operation can improve treatment outcomes.…”

Recent Advances in the Diagnosis and Management of Multiple Primary Lung Cancer

“…Most patients with MPLC are diagnosed with multiple ground glass opacities (GGOs) simultaneously, and therefore, surgery is the mainstay of management in the early stages of the disease [ 10 , 11 ]. The proportion of patients with sMPLC and 5-year survival rate is increasing, whereas the postoperative mortality is decreasing [ 12 ]. A previous meta-analysis revealed that age, sex, pulmonary function, smoking, tumor size, surgical methods, and lymph node status are prognostic factors for sMPLC [ 12 ].…”

“…The proportion of patients with sMPLC and 5-year survival rate is increasing, whereas the postoperative mortality is decreasing [ 12 ]. A previous meta-analysis revealed that age, sex, pulmonary function, smoking, tumor size, surgical methods, and lymph node status are prognostic factors for sMPLC [ 12 ].…”